目的：研究腺病毒介导的血管内皮生长因子（VEGF）165基因转移对新生大鼠缺氧缺血性脑损伤（HIBD）的神经保护作用。方法：采用细菌内同源重组技术构建Ad-VEGF腺病毒重组载体。7日龄Sprague-Dawley大鼠随机分成4组，假手术组（n=20）、HIBD组（n=25）、病毒缓冲液移植组（Buffer组，n=20），Ad-VEGF移植组（Ad-VEGF组，n=25）。使用Rice法制成HIBD模型，Ad-VEGF移植组和Buffer组在HIBD后3 d于大鼠左侧感觉运动皮层区分别立体定位注射2 μL重组体腺病毒悬液或病毒缓冲液；移植后7 d采用RT-PCR法检测鼠脑VEGF165 mRNA的表达；采用原位缺口末端标记法（TUNEL法）检测鼠脑皮质神经元凋亡情况； 采用免疫组织化学法分别检测VEGF蛋白表达及CD34表达计数大脑皮质微血管密度；30日龄时采用放射型迷宫觅水试验进行行为学测试，35日龄采用苏木精-伊红染色观察鼠脑组织病理学。结果：Ad-VEGF组VEGF165基因表达较HIBD组及Buffer组明显增高（P<0.05）；Ad-VEGF组脑细胞凋亡数目较HIBD组及Buffer组减少(P<0.05)；Ad-VEGF组平均大脑皮质微血管数及VEGF蛋白表达较HIBD组及Buffer组明显增多(P<0.05)； Ad-VEGF组行为学测试成绩较HIBD组及Buffer组改善(P<0.05)； Ad-VEGF组鼠脑皮层神经元变性坏死较HIBD组及Buffer组减轻。结论：腺病毒载体介导的VEGF165基因转移可增加新生鼠脑组织VEGF165 mRNA及VEGF蛋白的表达，减少脑细胞凋亡、增加新生脑血管形成，减轻缺氧缺血性脑损伤，改善远期学习记忆功能。

OBJECTIVE: To investigate the protective effects of adenovirus-mediated vascular endothelial growth factor (Ad-VEGF)165 gene transfer against hypoxic-ischemic brain damage (HIBD) in neonatal rats. METHODS: Ad-VEGF recombinant adenovirus was constructed by bacterial homologous recombination technology. Seven-day-old Sprague-Dawley rats were randomly assigned to 4 groups: sham-operated (n=20), HIBD (n=25), buffer-treated (n=20）, and Ad-VEGF-treated (n=25). The HIBD model was prepared by permanent occlusion of left common carotid artery, followed by exposure to 8 % oxygen for 2 hrs. In the Ad-VEGF-treated and the Buffer-treated groups, 2 μL recombinant adenovirus suspension or buffer was injected into the left sensorimotor cortex of the rat brain 3 days after HIBD. Seven days after transplantation, VEGF165 mRNA expression was detected using RT-PCR. Neuronal apoptosis was detected by the terminal deoxynucleotidyl transferase-mediated biotinylated deoxyuridine triphosphate nickel end labeling (TUNEL). CD34 and VEGF protein were detected using immunohistochemistry. Microvascular density in the cerebral cortex was measured based on CD34 positive cells. A radial arm maze test was performed from 30 postnatal days to evaluate long-term learning and memory functions. At 35 postnatal days, the rats were sacrificed for cerebral histological examinations by hematoxylin and eosin. RESULTS: The expression of VEGF165 mRNA increased in the Ad-VEGF-treated group more than in the untreated HIBD and the buffer-treated groups (P<0.05). The number of apoptotic neurons was less in the Ad-VEGF-treated group compared with that in the untreated HIBD and the buffer-treated groups (P<0.05). Microvascular density and VEGF positive cells increased in the Ad-VEGF-treated group compared with that in the untreated HIBD and the buffer-treated groups (P<0.05). In the radial arm maze test, the Ad-VEGF-treated group had more improved achievements than the HIBD and the buffer groups (P<0.05). Neuronal degeneration and necrosis were lessened in the Ad-VEGF-treated group compared with the HIBD and the buffer groups. CONCLUSIONS: Ad-VEGF gene transfer can increase the expression of VEGF mRNA and VEGF protein, decrease neuronal apoptosis, and increase angiopoiesis in the brain. This attenuates brain damage and improves long-term learning and memory functions in neonatal rats after HIBD.